Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain

Max, Mitchell B.; Donovan, Marilee I.; Miaskowski, Christine; Ward, Sandra E.; Gordon, Debra B.; Bookbinder, Marilyn; Cleeland, Charles S.; Coyle, Nessa; Kiss, Margaret E.; Thaler, Howard T.; Janjan, Nora A.; Anderson, Alice; Weinstein, Sharon M.; Edwards, William

doi:10.1001/jama.1995.03530230060032

Cited by 659 publications

(85 citation statements)

References 46 publications

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“…It is unethical to let the child suffer from pain without any trials to relieve pain or provide high-quality treatment. [4] This comes in the same line with the American Pain Society (1995) [5] which labeled the pain as "the fifth vital sign" to emphasize the importance of as-sessing pain frequently and providing appropriate treatment. The goal is to encourage health care professionals to assess pain every time and to institute measures to manage it.…”

Section: Introductionmentioning

confidence: 68%

Undergraduate nursing students' knowledge and attitude regarding pain management of children in Upper Egypt

Gadallah¹,

Hassan²,

Shargawy³

2017

JNEP

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Pain assessment and management require nurses to be equipped with adequate knowledge and proper attitudes. This research aimed to assess undergraduate nursing students' knowledge and attitude regarding pain management in children. Descriptive cross-sectional research design was utilized. This work was implemented at Faculty of Nursing in Assiut University. The study subjects consisted of convenient sample of undergraduate nursing students at third and fourth year during the academic year 2015-2016. One tool was used for this study consisted of two parts: part I: Demographic questionnaire, and part II: Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain (PNKAS). Fifty-six percent of undergraduate nursing students had unsatisfactory score regarding PNKAS. The highest percentage 76.2% of participating students had less than 50% of total score of knowledge and attitude regarding pain especially to pharmacological information. The study concluded that nursing students had poor knowledge and attitude regarding pain management by using PNKAS especially in the part of pain assessment and pharmacological pain management. The more contact with pediatric patients the higher the knowledge and positive attitudes among undergraduate nursing students. The study recommended that the pediatric staff should review the curriculum to enrich more about assessment and management of pain.

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Section: Introductionmentioning

confidence: 68%

Undergraduate nursing students' knowledge and attitude regarding pain management of children in Upper Egypt

Gadallah¹,

Hassan²,

Shargawy³

2017

JNEP

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“…This first question was drawn from a validated American Pain Society questionnaire17 and only adapted to indicate the ED setting. Patients were then asked whether they received analgesia.…”

Section: Methodsmentioning

confidence: 99%

Analgesia in the emergency department: why is it not administered?

Kant

Dombagolla²,

Lai³

et al. 2018

Emerg Med J

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ObjectivePain management in the ED is often suboptimal, with many patients not receiving analgesia. We aimed to determine why some patients refuse it, why others do not receive it, and whether these variables impact on patient satisfaction with their pain management.MethodsWe undertook a prospective, observational study in a large, Australian, tertiary referral ED (February–May 2017). A convenience sample of consecutive adult patients with a triage pain score of ≥4 were examined. Data were collected from the medical record and the treating nurses. At follow-up at least 48 hours postdischarge, patients were asked if they received analgesia in the ED (if not, then why not) and how satisfied they were with their pain management (very dissatisfied/dissatisfied/slightly dissatisfied/slightly satisfied/satisfied/very satisfied). The primary outcome was why patients refuse analgesia.ResultsOf the 651 enrolled patients, 171 (26.3%) did not receive analgesia; for 30 (17.5%), patients and their nurses agreed that analgesia was refused. Patients mainly refused analgesia because their pain was not bad enough, they had recent analgesia intake, and concerns about side effects and interactions. Patients who received analgesia were more likely to be ‘very satisfied’ with their pain management (difference in proportions 10.8%, 95% CI 2.1 to 19.4). The satisfaction of patients who refused analgesia and those who did not receive analgesia for other reasons did not differ.ConclusionPatient refusal is the most common reason for patients not receiving analgesia. Analgesia receipt is associated with greater patient satisfaction. However, a patient’s knowledge of their analgesia receipt status may be incorrect. Disregard of the reasons for patients not receiving analgesia may underestimate the number offered analgesia.

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“…Nurses often underestimate patients' pain (Sloman et al 2005, Idvall et al 2005) and vital signs can be influenced by other factors besides pain (Gelinas, Arbour 2009, Arbour, Gelinas 2010. Several guidelines advise healthcare professionals to administer additional analgesics when patients report an NRS score greater than 3 or 4 (Gordon et al 2005, Max et al 1995, VMS 2009, Hartrick, Kovan & Shapiro 2003. In a previous study, we reported that patients with NRS scores of 4, 5, or 6 vary in the interpretation of their score (Van Dijk et al 2012).…”

Section: Introductionmentioning

confidence: 98%

“…Patients' pain scores are the leading indicator in postoperative pain treatment (Idvall et al 2008, Gordon et al 2005, Max et al 1995, VMS 2009, Aubrun et al 2003. Clinical observations and physiological parameters used in pain treatment should be considered with caution.…”

Section: Introductionmentioning

confidence: 99%